Effects of BRCA1- and BRCA2-related mutations on ovarian and breast cancer survival: a meta-analysis
A partir d'une revue de la littérature (27 articles identifiés), cette méta-analyse évalue l'association entre des mutations des gènes BRCA1 ou BRCA2 et la survie des patientes atteintes d'un cancer du sein ou de l'ovaire
Purpose: To estimate the effects of BRCA1 and BRCA2 mutations on ovarian cancer and breast cancer survival.
Experimental Design: We searched PUBMED and EMBASE for studies that evaluated the associations between BRCA mutations and ovarian or breast cancer survival. Meta-analysis was conducted to generate combined hazard ratios (HRs) with 95% confidence intervals (CIs) for overall survival (OS) and progression free survival (PFS).
Results: From 1201 unique citations, we identified 27 articles that compared prognosis between BRCA mutation carriers and non-carriers in ovarian or breast cancer patients. Fourteen studies examined ovarian cancer survival and 13 studies examined breast cancer survival. For ovarian cancer, meta-analysis demonstrated that both BRCA1 and BRCA2 mutation carriers had better OS (HR: 0.76, 95% CI: 0.70-0.83 for BRCA1 mutation carriers; HR: 0.58, 95% CI: 0.50-0.66 for BRCA2 mutation carriers) and PFS (HR: 0.65, 95% CI: 0.52-0.81 for BRCA1 mutation carriers; HR: 0.61, 95% CI: 0.47-0.80 for BRCA2 mutation carriers) compared to non-carriers, regardless of tumor stage, grade, or histologic subtype. Among breast cancer patients, BRCA1 mutation carriers had worse OS (HR: 1.50, 95%CI: 1.11-2.04) than non-carriers, but were not significantly different from non-carriers in PFS. BRCA2 mutation was not associated with breast cancer prognosis.
Conclusions: Our analyses suggest that BRCA mutations are robust predictors of outcomes in both ovarian and breast cancer and these mutations should be taken into account when devising appropriate therapeutic strategies.
Clinical Cancer Research , résumé, 2014